Mr. Michael Adjabeng in his opening remarks welcomed all the participants for honouring the invitation to attend the workshop. According to him the work of Port Health Staff goes beyond case detection therefore there is the need to have in-depth knowledge in Infection Prevention and Control so as to take proper measures in handling suspected cases at the various Points of Entries (PoEs). The participants comprised environmental health staff and nurses working at the Points of Entry. This was the first time such a training was being conducted for PoE staff.

He entreated the participants to pay attention to whatever they will be taught at the workshop so that they can be ambassadors to propagate the knowledge they have acquired at the training to their colleagues at their various stations.

He informed participants of the Director General and Director of Public Health’s quest to put the knowledge to use after completion of training. The training was funded by DFID and this hereby acknowledged.

Objectives of Workshop

To prepare Points of Entry staff in handling and managing infections or infectious items when any is detected.

Identify the gaps in Infection, Prevention and Control (IPC) skills and knowledge

Address the gaps identified in IPC skills and knowledge

To provide updates on new developments in IPC among others.

Methodology

Gaps in IPC knowledge were identified through questions and description of routine activities at duty post. Other methods used were PowerPoint presentations, discussions, demonstrations, revising previous day’s lessons and practical sessions with involvement of every participant. An evaluation session was finally conducted.

Presentation on Overview of Infection Prevention and Control (IPC) by Gloria Ntow-Kummi

The facilitator IPC is a broad topic which needs ample time especially as skills and demonstrations are involved. She gave an overview of the topics to be discussed and asked full participation.

Presentation on Introduction to Infection Prevention and Control (IPC) and Healthcare Associated Infections (HAIs) by Madam Agnes Cudjoe

She said IPC refers to procedures and practices employed to reduce risk of spreading infection especially in healthcare facilities. She also mentioned that, IPC deals with preventing the spread of diseases through infectious blood and body fluid via airborne, droplet, contact including faecal-oral and food borne routes. She did mention that, it is a must to practice IPC everywhere so as to ensure the protection of the person handling the issue.

She further explained that Healthcare Associated Infection also known as nosocomial or hospital infection is infection occurring in a patient during the process of care in a health facility which was not present or incubating at the time of admission. It includes the infection acquired at the healthcare but appearing after discharge and also occupational infection among health workers.

According to her, infection can manifest itself within 48-72 hours or more after admission. She said infection can range from mild to fatal depending on the host’s immune system. She added that, the length of time of exposure, mode of exposure, virulence and number of organism and state of the host’s defenses are factors that determine which organisms and agent responsible for infection. She also talked on burdens of HAIs, impact and effect and disease transmission cycle. She mentioned that some organisms are more pathogenic than others and infection can occur when micro-organism invade the host. She said all human beings are susceptible host to infection. She proceeded by saying that, before infection can occur the following must be present; the Agent, Reservoir, Place of exist, method of transmission, place of entry and susceptible host. She brought her presentation to an end by thanking the participants for paying attention to her.

Mr. Abrefa said precaution is categorized into two sets namely; Standard Precaution and Transmission Based Precaution. He added that, precaution is a measure put in place to avoid a person from been infected. He added that the two set of precautions are used to break disease transmission cycle by using physical or chemical barriers. He added that Standard Precaution is recommended for treatment of all patients/clients and is required for everyone; health workers, patients and visitors.

Mr. Abrefa further stated that, Standard precaution has 12 components. He asked the participant to always have the assumption that everyone may be infected with pathogen. He said Standard Precaution must be used when dealing with infectious substances. He said Transmission Based Precaution is use when the route of transmission is completely interrupted using standard precaution. In addition he said Transmission Based Precaution is mostly use when dealing with patient with high infectious diseases and suspected patient. He said it may be use for disease with multiple route of transmission. He mentioned that the more difficult the condition, the more the precaution measures needed to be used. On the issue of cough etiquette he said people can easily spread the microbes to others without applying the etiquette. He said the cough etiquette practices encourage reduction in the spread of microbes in the form of droplets.

Figure 2 Practical session on wearing of PPEs

Presentation on Hand Hygiene by Madam Gloria Ntow-Kummi

Hand hygiene is very important in every health worker’s daily activities. According to her, the hand is one of the busiest parts of the body. She said based on research, hand hygiene is the most important part in Infection Prevention and Control. She added that the hand of the health worker can easily get contaminated in the course of taking pulse, blood pressure readings and temperature. She mentioned that everybody has various kind of micro-organism on their body but these organisms become pathogenic when their location change to favour their spread. On colonization and infection, she said people carry bacteria without any evidence of infection. According to her, germs multiply in numbers which needs regular hand washing to deal with. She said the use of communal towel should be avoided.

She added that though hand hygiene is important among health workers, there are some barriers such as heavy workload (too busy), poor location of sinks, lack of soap and other hand drying materials, skin irritation caused by frequent exposure to soap and water, hands do not look dirty, hand washing takes too long, many staff not realizing that they have germs on their hands, feeling of low risk of acquiring infections, understaffing/overcrowding among others are the factors that discourage the practice of hand hygiene.

Practical demonstration on the use, wearing and removal of PPE by Mr. George Abrefa

The facilitator took the participants through the use, wearing and removal of the various kinds of Personal Protective Equipment (PPE). The participants were made to practice the use, wearing and removal of the PPE.

Presentation on decontamination of used items and healthcare waste management by Madam Agnes Codjoe

She said disease transmission cycle needed to be broken and one of the methods that can be used in breaking this transmission cycle is to decontaminate. She added that decontamination is the first step in processing instruments or objects for reuse and it should be done after the instrument has been used.

She explained decontamination as the process of removal or destruction of most micro-organisms to render a surface or objects safe to handle. She took the participants through how to prepare 0.5% or 0.05% chlorine solution. Various market concentrations were given for participants to calculate the required 0.5% or 0.05% chlorine solutions.

She said healthcare waste can be classified as follows; General or normal waste are not generally harmful-(office waste, kitchen waste), Infectious wastes (wastes generated by inpatient and outpatient activities that are likely to contain harmful infectious organisms, such as soaked dressings, used sharps and used needles, pathological waste, placentas, etc.) and Toxic wastes (pharmaceutical wastes, electronic wastes, and radioactive wastes).

She demonstrated how healthcare waste should be managed by using the available cleaning materials. Participants nevertheless expressed their concern that they were not having all equipment in place to help IPC measures.

Evaluation Results

The participants were also given evaluation forms to evaluate the training workshop. Twenty three participants took part in the evaluation. Ten participants (47.6%) mentioned that presentations were clear. Another 24(96%) indicated the level of workshop was appropriate. Participants (65%) indicated that hand hygiene was among the topics they found most useful. The availability of logistics remained a threat to ably practice IPC measures as learnt.

Conclusion

Mr. Michael Adjabeng entreated all the participants to ensure that they utilize the knowledge they have acquired at the workshop to effect a change at their various stations. He commended the participants for submitting themselves to the training and wished them safe journey to their various destinations. The IPC policy guidelines were distributed to Tatale, Sampa, Elubo, Paga, Oseikojokrom and Hamile PoEs with plans made to provide the others later. Participants expressed their satisfaction on having learnt new skills which will help ensure appropriate IPC measures are in place. A WhatsApp Group was created to help respond to technical challenges that might be encountered by participants when they are rolling out.